Plain English Summary
http://cancerhelp.cancerresearchuk.org/trials/a-trial-looking-at-gsk1120212-people-melanoma
Trial website
Contact information
Type
Scientific
Primary contact
Dr Shama Fernando
ORCID ID
Contact details
Oncology Clinical Trials Office
Department of Oncology
Old Road Campus
Roosevelt Drive
Headington
Oxford
OX3 7DQ
United Kingdom
-
PACMEL@octo-oxford.org.uk
Additional identifiers
EudraCT number
2011-002545-35
ClinicalTrials.gov number
Protocol/serial number
12095
Study information
Scientific title
A randomised phase II study of paclitaxel with or without GSK1120212 in advanced wild type BRAF melanoma
Acronym
PACMEL
Study hypothesis
This is a randomised multi-centre study. 80 patients (forty in each of 2 arms) with melanoma will be randomly assigned to receive treatment with paclitaxel chemotherapy or the same drug along with GSK1120212, a new medicine. To take part the patient's melanoma must have a normal BRAF gene (at V600), which is about 60% of people with melanoma. This can be checked on a sample of the patient's tumour (usually one that has already been taken as part of their treatment). Prior to the randomised part of the study, between 9 and 18 patients will take part in the trial to establish the best dose of GSK1120212 and paclitaxel in combination.
Ethics approval
NRES Committee South Central - Oxford, 23/01/2012, ref: 11/SC/0458
Study design
Randomised interventional phase II trial
Primary study design
Interventional
Secondary study design
Randomised controlled trial
Trial setting
Hospitals
Trial type
Treatment
Patient information sheet
Not available in web format, please use the contact details below to request a patient information sheet
Condition
Melanoma
Intervention
Dose Escalation Phase: Patients with advanced melanoma will be recruited into 3 dose level cohorts. Three dose levels of GSK1120212, starting at 1.0 mg for the first cohort and escalating by 0.5 mg to 1.5 mg and 2.0 mg for the second and third cohorts respectively. At all dose levels, GSK1120212 will be administered once daily orally in combination with an 80 mg/m2 IV infusion of paclitaxel on Days 1, 8 and 15 of each 4 week cycle. This phase will determine the maximum tolerated dose of GSK1120212 in combination with paclitaxel for the randomisation phase. Paclitaxel will be administered for up to 6 cycles, but GSK1120212 may be continued until disease progression or intolerable toxicity.
Randomisation Phase: Two treatment arms:
1. Maximum 6 cycles of single agent Paclitaxel alone as an 80mg/m2 IV infusion on Days 1, 8 and 15 of each 4 week cycle
2. Maximum 6 cycles of Paclitaxel as an 80mg/m2 IV infusion on Days 1, 8 and 15 of each 4 week cycle in combination with maximum tolerated dose of GSK1120212 once daily orally.
GSK1120212 may be continued until disease progression or intolerable toxicity.
Patients will be followed up every 3 months until disease progression.
Intervention type
Drug
Phase
Phase II
Drug names
trametinib (GSK1120212), paclitaxel
Primary outcome measure
1. Efficacy of GSK1120212 in combination with paclitaxel compared to paclitaxel alone
2. Progression free survival
Secondary outcome measures
1. Further efficacy of GSK1120212 in combination with paclitaxel compared to paclitaxel alone
2. Overall survival
3. Objectine response rate
4. Progression free survival at 6 months
Overall trial start date
13/04/2012
Overall trial end date
30/04/2016
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
1. Aged = 18 years
2. Able to provide evidence from an accredited laboratory of wt BRAF status for their melanoma, or ascertainment of wild type BRAF status from a sample of melanoma provided for mutational analysis in Oxford (phase 2 part only).
3. Unresectable stage 3 or 4, histologically proven cutaneous or unknown primary melanoma
4. Measurable disease as defined by RECIST 1.1 (phase 2 part only)
5. ECOG performance score of 0 or 1
6. Life expectancy of at least 12 weeks.
7. Maximum 2 prior lines of treatment for advanced disease.
8. Adequate cardiac function (NYHA 0-1), and LVEF within normal limits on echocardiogram.
9. The patient is willing to give consent to the main study and able to comply with the protocol for the duration of the study, including scheduled follow-up visits and examinations.
10. Adequate haematological, hepatic and renal function
11. Target Gender: Male & Female
12. Lower Age Limit 18 years
Participant type
Patient
Age group
Adult
Gender
Both
Target number of participants
UK Sample Size: 98 - a max of 18 patients will be recruited to the dose escalation phase to determine the max tolerated dose. 80 patients will be recruited into the randomised phase II study
Total final enrolment
111
Participant exclusion criteria
1. Any systemic anti-cancer therapy (including participation in other clinical trials) within 28 days prior to Day 1.
2. Any radiotherapy within 14 days prior to Day 1.
3. Prior taxane or BRAF or MEK inhibitors for metastatic melanoma.
4. Any unresolved toxicity from prior anti-cancer therapy that is greater than CTCAE grade 2.
5. Pregnancy or breastfeeding women. Female patients must have a negative urinary or serum pregnancy test or have evidence of post-menopausal status (defined as absence of menstruation for > 12 months, bilateral oophrectomy or hysterectomy).
6. Grade =2 peripheral neuropathy at study entry.
7. Patients of reproductive potential who are not willing to use adequate contraceptive measures for the duration of the study (both male and female patients)
8. Known severe hypersensitivity reactions to paclitaxel or other drugs formulated in Cremophor EL and ethanol
9. Ocular or mucosal malignant melanoma
10. Another active malignancy within the past three years.
11. Evidence of brain metastases, unless surgically resected/stereotactic radiosurgery treated brain metastasis with no evidence of relapse on cerebral MRI, or treated brain metastasis and stable off treatment, including steroids, for 3 months.
12. Clinically significant and uncontrolled major medical condition(s): such as active infection, bleeding diathesis.
13. Patients who are known to be serologically positive for Hepatitis B, Hepatitis C or HIV.
14. Inability to swallow tablets, refractory nausea and vomiting, chronic gastrointestinal diseases (eg, inflammatory bowel disease) or significant bowel resection that would preclude adequate absorption.
15. Ocular disease predisposing to central serous retinopathy and/or retinal vein occlusion, including increased intraocular pressure, glaucoma, uncontrolled hypertension or uncontrolled diabetes.
Recruitment start date
20/04/2012
Recruitment end date
30/04/2016
Locations
Countries of recruitment
United Kingdom
Trial participating centre
University of Oxford
Oxford
OX3 7DQ
United Kingdom
Sponsor information
Organisation
University of Oxford (UK)
Sponsor details
Clinical Trials and Research Governance
Joint Research Office
Block 60
Churchill Hospital
Headington
Oxford
OX3 7LJ
United Kingdom
Sponsor type
University/education
Website
Funders
Funder type
Industry
Funder name
GlaxoSmithKline (UK)
Alternative name(s)
GlaxoSmithKline plc., GSK
Funding Body Type
private sector organisation
Funding Body Subtype
For-profit companies (industry)
Location
United Kingdom
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Basic results (scientific)
Publication list
1. 2015 results for dose escalation phase in https://www.ncbi.nlm.nih.gov/pubmed/25542057
2. 2018 results in: https://www.ncbi.nlm.nih.gov/pubmed/30428063
3. 2020 results in https://www.ncbi.nlm.nih.gov/pubmed/31987431 (added 29/01/2020)